Sa1661 Effect of Rebamipide for Endoscopic Submucosal Dissection (ESD) -Induced Ulcer in Early Gastric Cancer: A Randomized Controlled Trial

Abstract

Sa1661 Effect of Rebamipide for Endoscopic Submucosal Dissection (ESD) -Induced Ulcer in Early Gastric Cancer: A Randomized Controlled Trial Shigenaga Matsui*, Masatoshi Kudo, Hiroshi Kashida, Yutaka Asakuma, Toshiharu Sakurai, Masanori Kawasaki Gastroenterology and Hepatology, Kinki University,Faculy of Medicine, Osaka-sayama, Japan Backgroud and Aim: Endoscopic submucosal dissection (ESD) is useful for treating early gastric cancer. The artificial ulcer that is generated after ESD is large, and needs a considerably longer healing time compared with conventional endoscopic mucosal resection (EMR). Rebamipide is one of the mucoprotective antiulcer drug, and is widely employed treatment of gastric ulcer in Japan. This study investigated prospectively differences in healing of ESD-induced ulcers according to treatment with proton pump inhibitor (PPI) or rebamipide only. Methods: A total of 54 early gastric cancer patients who had undergone ESD were enrolled in this study. Patients underwent ESD and received an intravenous infusion of lansoprazole (20mg) every 12 hours for 2 days. These patients were then randomly assigned to two groups receiving either lansoprazole (30mg p.o,b.i.d; PPI group, n 27) or rebamipide ( 300mg p.o,b.i.d; RM group, n 27). At 4 and 8 weeks after ESD, the healing rates were compared with those of the ESD-induced ulcers. Results: In both groups, no significant differences were seen however in term of age, gender, underlying disease, site of cancer, the rate of Helicobacer pylori infection or ESD-induced ulcer size. At 4 weeks, the healing rate were not significant in the PPI group (22.2%) compared with the RM group (29.6%) (p 0.5346). At 8 weeks, the healing rates were not significant in the PPI group (85.2%) compared with the RM group (88.9%) (p 0.6854). At 8 weeks after ESD, no significant differences were observed between the two groups in terms of ulcer-related symptoms. PPI of the cost which was required of eight weeks was 10,945 yen, and the price of RM was 48,886 yen. Complications derived from drugs or ulcer bleeding of post ESD were not observed in any of our 54 study subjects. Conclusion: Rebamipide were the equivalent efficacies compare with the PPI alone in healing of ESDinduced ulcer. It has the advantage that rebamipide have cost benefit.